Anxiety disorders

Anxiety disorders are conditions in which symptoms of anxiety are so severe or occur so regularly, they start to interfere with everyday life. About 14 percent of Australian adults are affected by an anxiety disorder in any one year. This equates to about one in seven people.

About anxiety disorders

Anxiety is a feeling of unease. Everybody gets anxious when faced with a stressful situation, for example an exam or interview, or during a worrying time such as illness. It's also normal to feel anxious when you face something difficult or dangerous. Mild anxiety can often be positive and useful, particularly if you're better at working under pressure.

However, an anxious mood becomes an anxiety disorder when it's long-lasting, severe and interferes with your everyday activities. Excessive anxiety is often associated with other mental health problems such as depression.

Types of anxiety disorder

Below are some examples of anxiety disorders.

Phobias

A phobia is a fear that's out of proportion to any real danger. If a phobia interferes with your ability to lead a normal life, then it may be considered an anxiety disorder. Common phobias include fears of heights, spiders, mice, blood, injections or enclosed spaces.

Social anxiety disorder

Social anxiety disorder, also known as social phobia, is a powerful and persistent fear of social or performance situations. If you have this condition you fear being closely observed or negatively judged by others to such an extent that you'll avoid certain social situations or experience severe distress if you do involve yourself in them. You may also limit what you do in front of others, such as eating in public, or even isolate yourself from others in order to avoid social interaction.

Panic disorder

If you have panic disorder, you can suddenly develop intense periods of fear known as panic attacks. You may find that something specific triggers your panic attacks, or they may develop for no apparent reason. Panic attacks usually last five to 10 minutes but they can last longer.

Obsessive-compulsive disorder

If you have obsessive-compulsive disorder (OCD), you may have repeated obsessions and/or compulsions that make you feel anxious. OCD symptoms vary from mild to severe. They include obsessions (recurrent ideas that make you feel distressed or anxious) and compulsions (actions or rituals which you feel necessary to cancel out the obsessions).

Post-traumatic stress disorder

You can develop post-traumatic stress disorder (PTSD) if you've had or witnessed a traumatic event. PTSD symptoms include anxiety, which may come and go, and recurring thoughts, memories, images, dreams or distressing flashbacks of the trauma. PTSD may develop years after the traumatic event occurred.

Generalised anxiety disorder

Anxiety can be a long-term disorder where you feel worried most of the time about things that might go wrong. This is called generalised anxiety disorder (GAD). If you have GAD, you may also have panic attacks and some phobias.

Symptoms of anxiety disorders

Anxiety disorders can cause both psychological and physical symptoms.

If you have an anxiety disorder, your main symptom will be feeling anxious. However, this can lead to other psychological symptoms such as:

sleeping difficulties (insomnia)

feeling tired

being irritable or quick to get angry

being unable to concentrate

a fear that you're 'going mad'

feeling out of control of your actions, or detached from your surroundings.

When you're anxious, you may also have a range of physical symptoms. This is caused by the release of the hormone adrenaline - your body's so-called 'fight or flight' response. Physical symptoms of anxiety include:

discomfort in your abdomen (tummy)

diarrhoea

dry mouth

rapid heartbeat or palpitations

tightness or pain in your chest

shortness of breath

dizziness

needing to urinate more often than usual

difficulty swallowing

shaking

These symptoms may be caused by problems other than anxiety disorders. If you have any of these symptoms, see your doctor for advice.

Causes of anxiety disorders

There are many different causes of anxiety. It may not be clear why you have anxiety, but you may be more likely to develop an anxiety disorder if you:

go through a stressful, life-changing event such as a bereavement, or witness something traumatic

have another mental health condition, such as depression or alcohol dependence

have a physical illness, such as a thyroid disorder

take illegal substances such as amphetamines, LSD and ecstasy

are withdrawing from long-term use of some medicines, such as tranquillisers.

Some people seem to be born with a tendency to be more anxious than others. This means anxiety disorders may be genetically inherited. Equally, people who are not naturally anxious can become so if they're put under intense pressure.

Diagnosis of anxiety disorders

Your GP will want to identify what's causing your anxiety. They will ask about your symptoms and examine you.

In some circumstances your GP may refer you to a counsellor, therapist or psychiatrist for further diagnosis to help determine what treatment is appropriate for you.

Treatment of anxiety disorders

Self-help

There are various lifestyle changes you can make to help reduce feelings of anxiety. For example, taking part in regular physical activity, avoiding stimulants such as cigarettes and alcohol and eating a healthy diet can help to improve your symptoms.

A good source of support and advice can be charities and patient groups where you can get into contact with and talk to other people who have anxiety disorders. Your GP may be able to advise you about services available in your area.

Talking therapies

Your GP may refer you to a counsellor or a therapist for treatment. Talking through your problems with a counsellor may help you to deal better with your anxiety. Counselling may be particularly helpful if you have a panic disorder, social phobia or GAD, especially in the short term, but it isn't suitable for everyone.

Cognitive behavioural therapy (CBT) is a short-term psychological treatment. CBT helps to challenge negative thoughts, feelings and behaviour, and is particularly suitable if you have problems such as phobias or panic attacks.

Medicines

There are a number of different types of medicines that can be used to treat anxiety disorders. Your GP may prescribe you one of the following medicines, depending on how much your anxiety affects you.

Antidepressants are the main drug treatment of choice for anxiety. They can be used on their own for chronic anxiety or in combination with a benzodiazepine.

Benzodiazepines may be used for the short-term relief of severe anxiety. They aren't prescribed for long-term use because of the risk of addiction.

Beta-blockers may help to reduce some of your physical symptoms, such as rapid heartbeats or palpitations and shaking. However, they don't help with the psychological symptoms of anxiety.

Complementary therapies

Some relaxation techniques, such as meditation, low impact yoga or tai chi exercises, may help you to deal with your anxiety. However, there isn't enough research on these types of therapy to tell if they're effective or not. You should always speak with your GP before you start any complementary therapy courses or treatments.

RANZCP Clinical Practice Guidelines Team for Panic Disorder and Agorophobia. Australian and New Zealand clinical practice guidelines for the treatment of panic disorder and agoraphobia. [online] 2003 [Accessed 7 Jul 2011] Available from: http://www.ranzcp.org/

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